Provider Digital Issue Research & Resolution Project Manager, CVS Health

CVS Health

Location:
United States

Category:
IT - Administration

Contract Type:
Employment contract

Salary:

54300.00 - 159120.00 USD / Year

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Job Description:

This role is for a position on the Issue Research and Resolution team within Provider Digital Operations organization. It involves support of our Digital Portal and provider electronic data interchange transactions. Main responsibilities include receiving issues directly from our Digital Portal users and internal customers, problem solving/troubleshooting, identification of appropriate systems based on the issue at hand, prioritization of issues and communicating complex technical details in a business-friendly manner understandable to our customers.

Job Responsibility:

Maintain colleague access to the Digital Portal
Review colleague requests for portal access
Utilize reports to remove colleagues who no longer require access
Handle incoming support tickets related to Digital Portal functionality
Use knowledge of the Portal and Systems to determine whether the ticket is Portal-specific or not
Respond to resolved tickets
Send to EDI Consultants if issue requires more detailed Aetna system analysis
Identify new/trending issues and share with manager
Represent the Digital Portal during Aetna Immediate Response Team (IRT) issue calls
Act as liaison between the IRT and the Digital Portal team
Monitor Availity downtime/performance issues
Assist with communications related to the Digital Portal
Represent the Digital Portal on the Intake & Digital Operations Work Intake Committee
Support the Digital Portal Change Request (CR) process
Act as the liaison between the requester and the Digital Portal team
Share CR form with the requester
Meet with them to ensure form is sufficiently completed
Submit the form to the Digital Portal team
Schedule and facilitate bi-weekly CR Review meetings
Act as the single point of contact for Change Requests
Ensure that updates are shared with requesters
Obtain answers to questions on behalf of requesters

Requirements:

Working knowledge of the provider Digital Portal
2-4 years related work experience in the Provider Contact Center
2-4 years of EPDB experience
1-3 years of EWM experience
1-3 years of Salesforce/GPS experience
Advanced skills in Outlook
Bachelor's degree or equivalent experience of 2-4 years

Nice to have:

1-3 years of Service now experience
3-5 years of experience in usage of EWM
1-3 years of ACAS experience
1-3 years of ICD-10, HCPCS, CPT experience
Exposure to AEPPAYS
Proficient use in Excel

What we offer:

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
No-cost wellness screenings
Tobacco cessation and weight management programs
Confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance
Retiree medical access

Additional Information:

Job Posted:
October 18, 2025

Expiration:
October 31, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Provider Digital Issue Research & Resolution Project Manager